1.	Project Details

   Whether it is a violation case and application is being submitted under Notification No. S.O.804(E) dated 14.03.2017 ? : No

1.	Project Details

   i. Proposal No. : IA/GJ/IND2/66866/2017    ii. MoEFCC File No. : SIA/GJ/19703/2017    iii.Short narrative of the project: M/S. KETIX CHEMICALS    iv. Project Sector : Industrial Projects - 2    v. Company/Proponent : KETIX CHEMICALS

vi.Details of State of the project

Details of State of the project
S.no.	State Name	District Name	Tehsil Name
1.	Gujarat	Bharuch	Anklesvar

   vii.Date of TOR Granted 01 May 2017 viii.TOR letter issued by Ministry: Annexure-TOR letter ix.Date of Submission for EC: 21 Jul 2017 x.Project Type: New

2.	Uploaded Documents of EIA/EMP,Risk Assessment,Public Hearing etc.

i.EIA/EMP: Annexure-EIA/EMP ii.Risk Assessment: Annexure-Risk Assessment iii.Public Hearing: Annexure-Public Hearing    iv. Date of Public Hearing: 08 May 2017   v. Uploaded Additional Report/Study/Document as desired by Ministry/EAC: None   vi. Uploaded Cover Letter: Annexure-Cover Letter   vii.Remarks: NIL

3.	Additional Detail Sought:   NIL

4.	Accredited Consultant Details

   i. Accreditation status : Yes    ii. Accreditation No. : High Court Stay Order    iii. Name of Consultant: Jyoti Om Chemical Research Centre Pvt. Ltd.   iv. Address : Shed No.K-1, 7705/2,3,4, GIDC Estate, Ankleshwar-393002   v. Mobile No.: 9824150383   vi. Landline No.: 02646220293   vii. Email Id: info@jyotiom.com

5.	Undertaking

I hereby give undertaking that the data and information given in the application and enclosures are true to be best of my knowledge and belief and I am aware that if any part of the data and information found to be false or misleading at at any stage, the project will be rejected and clearance given, if any to the project will be revoked at our risk and cost.

   i. Name of Applicant : Mitesh    ii. Designation : Properietor    iii. Name of Company(Applicant Name should not be given here) : KETIX CHEMICALS    iv. Address : Plot No. 501/K, GIDC Estate, Ankleshwar. v. Uploaded copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency: Annexure-Uploaded copy of documents in support of the competence/authority of the person making this application to make application on behalf of the User Agency